Narrative medicine and reflective practice among providers: Connecting personal experiences with professional action for ACP.

9 Background: Increasingly, Narrative Medicine (NM) is utilized in clinical experiences. Critical reflection is a core aspect of NM providing the narrative competence to “recognize, absorb, interpret, and honor” the stories of self and other. This study evaluates the effectiveness of a NM workshop to: 1) develop skills in attending and responding to the stories of others as a part of advance care planning (ACP) conversations and 2) reflect on their own stories of loss in relation to professional practice. Developing narrative skills may help overcome barriers to successful ACP with patients and families. Methods: 29 health care professionals completed a continuing education course on NM principles for end-of-life care. Workshop activities included a close reading on a professional’s story of personal loss and a reflective writing exercise sharing one’s own personal story of loss. Small groups debriefed after each exercise. 24 participants (83%) completed post-workshop surveys including closed and open-ended questions. Results: Mean age of participants was 50.3 (SD 14.7), 87% were female, and 92% White. Social workers represented 71% of the sample with clinicians across several specialty areas. Findings indicate 80% of participants strongly agreed the experience of writing about their own experiences of loss helped develop their communication skills and 88% strongly agreed the experience of listening to stories of others helped develop their communication skills and they would use skills from the workshop in practice. Common themes from qualitative analysis included the usefulness of techniques for framing difficult conversations, patient vulnerability, the importance of active listening, and increased empathy for the storyteller. Common themes reflecting on providers’ personal stories of loss included recognition of prior experience on professional interactions and reported improved skills in authentic interactions and increased capacity for empathy. Conclusions: NM competencies have the potential to enhance communication surrounding ACP. Providers find the NM approach to be a useful framework for engaging in difficult conversations about end-of-life.